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General NPI Number Information
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NPI Number | 1053187369
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Entity Type | Organization
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Legal Business Name | KMEDICALSUPPLY1.COM
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Dates
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Enumeration Date | 11/28/2023
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 2146 SWORD DR
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City | GARLAND
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State | TX
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Zip | 75044-6028
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Country | US
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Telephone | 972-209-3888
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Fax |
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Provider Business Mailing Address
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Address Line | 2146 SWORD DR
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City | GARLAND
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State | TX
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Zip | 75044-6028
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Country | US
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Telephone | 972-209-3888
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Fax | 972-767-0148
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KIMLOAN TRAN
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Credential |
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Telephone | 972-209-3888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State |
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